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Treatment is the key link of syndrome differentiation and treatment.Chinese medicine has many kinds of therapeutics and methods.They should be used flexibly according to the characteristics of Pediatrics,so as to improve the clinical efficacy.
For children,“diseases occur as powerful as horses; the changes are as fast as lightning”.Improving or exacerbating is an occurrence in a wink.It is,therefore,especially important to grasp the pathogenesis,and apply treatment in time.Qi of zang-fu organs in children is clear,and responds quickly.So the key in pediatric treatment is to make clear diagnosis,accurate syndrome differentiation and correct medication.Therefore,whether the medicine is correct or not is related to the progress of the illness.
Treatment with great caution gives priority to medicines selection.When medicating children,if the properties of the medication are even a bit too moist or greasy,spleen-stomach function will be impeded; if the medication is a little too harsh in elimination,healthy qi will be impaired; if pattern identification is slightly incorrect,then treatment will deviate.If treatment is only based on guesswork,this will cause further deviation from the correct treatment and lead to more serious conditions.So great caution should be paid to the selection of medicinals for children,especially for neonates and infants.Diseases are caused by yin-yang imbalance,and the imbalance is closely related to the characteristics of yin and yang in children.Medicinals have four properties: cold,hot,warm and cool.Careless use can lead to new imbalance between yin and yang,resulting in other illness.Try to choose the medicine suitable for the physical characteristics of children.Be cautious about using those extremely pungent,hot,bitter and cold,as well as those with toxin,strong effect tranquilizing,attacking and drastic purgation.Pay attention to the dose,the timing and methods.If such medicinals are necessarily employed,they should be stopped immediately when the condition is resolved or even soon after significant improvement appears.
Children have clear zang -qi which responds quickly; therefore,when they are treated,the prescriptions or medicinals should be light and flexible,avoiding those large formulas with unclear purpose and disorderly accumulation,especially those with drastic nature which should be strictly controlled about the amount.Pediatric dosages of Chinese medicine often vary in age,individual difference,disease severity,prescription combination,and the number of ingredients,and the taste and nature,texture and weight,and the toxicity,and should be combined with clinical experience.In general it should be controlled within the dose prescribed in Pharmacopoeia of the People’s Republic of China .Medication should be appropriate,and the dosage should be accurate.
Pediatric medication is usually dominated by decoctions,but there are disadvantages of decoction.For example,it is inconvenient to taking decoction,and its slow action cannot save a critical situation (Water from afar cannot extinguish a fire nearby).Oral liquid or syrups are available for infants.Pills or tablets that cannot be swallowed should be ground and added with water before being taken.Granules and extracts can be dissolved and diluted in warm water before taking.In order to avoid medication difficulties,suppositories or rectal administration may be applied.Injection may be used when necessary.Injection is an ideal method of administration in pediatrics due to its quick effect,but the dosage,indications and contraindications should be strictly controlled to prevent potential adverse reaction.
Medicinal amounts for children should be controlled by their total dosage.Compared to adults,1/6 is available in neonates,1/3 in infants,and 1/2 to 2/3 in toddlers,schoolaged children are close to adults in dosage.The dosage for children can be controlled according to the condition and clinical experience by diminishing the number of ingredients in a formula,or by reducing the amount of a single medicinal.When decocting,it is necessary to know whether there are drugs decocted first,decocted later,wrap-boiling or decocted separately.Before making a decoction,all medicinals should be soaked in clean water.Decoction time is determined by the function of the prescription.The total amount is 30 to 50 mL for neonates,60 to 100 mL for infants,150 to 200 mL for toddlers,and 200–300 mL for school-age children.According to the patient’s condition,the decoction is divided into 3–5 parts,which are administered in one day.Avoid administering the child by force.
Pathogenetic condition determines the choice of drugs for oral administration or external treatment.A lot of external treatments in Chinese medicine should be recommended,such as fumigation and washing method,coating method,hot-compressing method and application method etc.The combination of internal and external treatment may obtain faster or better curative effect.For example,infantile diarrhea can be cured with oral prescriptions and administration on the umbilicus at the same time; mixture of Rú Yì Jīn Huáng Săn (Will-Following Golden Yellow Powder,如意金黄散) and vinegar applied to swollen part of mumps,along with prescriptions for clearing heat,removing toxin,reducing swelling,and removing stasis can promote the early recovery of mumps.
In conclusion,for pediatric diseases,no matter what methods,the internal treatments,external therapies or other treatments must be adjusted to illness,to time and to local conditions.None can be neglected.
After identifying the etiology,analyzing the pathogenesis,and differentiating the disease patterns,specific treatments should be employed by assessing the risks and benefits.Among the treatment methods,the most basic are sweating,emetic vomiting,purgation,harmonizing,warming,clearing,tonifying and resolving.According to the characteristics of Pediatrics,and according to the eight principles,the following 12 methods are often used,which are often used alone and often combined.
This method is mainly applicable for exterior patterns caused by external pathogens invading the fleshy exterior.As external pathogens constrain the exterior,the pores fail to open and close properly,causing fever,aversion to wind,and sweating in some cases.In this situation,medicinals that induce sweating are used to scatter and dissipate external wind and to release pathogenic toxins from the body surface.Clinically there are two groups: pungent-warm and pungent-cool,represented by Xìng Sū Săn (Apricot Kernel and Perilla Powder,杏苏散) and Yín Qiào Săn (Lonicera and Forsythia Powder,银翘散).
This method is mainly applicable for cough and dyspnea caused by pathogens stagnating in the lung meridian and phlegm obstructing the lung collaterals.Latent internal coldphlegm syndrome can be treated with prescriptions for warming lung,dispelling cold,resolving phlegm and relieving panting,such as Xiăo Qīng Lóng Tāng (Minor Green Dragon Decoction,小青龙汤), Shè Gān Má Huáng Tāng (Belamcanda and Ephedra Decoction,射干麻黄汤); internal phlegm-heat accumulation can be treated with prescriptions for clearing heat,resolving phlegm,diffusing the lung and relieving panting,such as Dìng Chuăn Tāng (Arrest Wheezing Decoction,定喘汤), Má Xìng Shí Gān Tāng (Ephedra,Apricot Kernel,Gypsum and Licorice Decoction,麻杏石甘汤).In the case of chronic cough,the disease tends to develop from lung to kidney and thus display the pattern of kidney deficiency.Then add medicinals that warm the kidney and improve qi receptions,such as Shēn Gé Săn (Ginseng and Gecko Powder,参蛤散) into the formula to relieve cough and panting.
This method is mainly applicable for excess heat patterns with exuberant heat toxins such as in warm-febrile diseases,dampheat diseases,macula,blood patterns,erysipelas,sores,and carbuncles.Internal heat can be cleared with sweet-cold,bitter-cold,bitter-purgative,or salty-cold medicinals.Formulas and medicinals need to be selected according to the locations of the pathogenic heat,and according to whether the heat is exterior or interior,belongs to qi or blood levels,and whether it has entered into zang or fu organs.
If pathogens are entering the interior from the exterior but the external pathogens have not been fully resolved,use
Zhī Z
Ch
Tāng
(Cape Jasmine fruit and Prepared Soybean Decoction,栀子豉汤) and
Gé Gēn Qín Lián Tāng
(Pueraria,Scutellaria,and Coptis Decoction,葛根芩连汤) to clear heat,resolve toxins and vent pathogens.If due to
yangming
interior heat,use
Bái Hǔ Tāng
(White Tiger Decoction,白虎汤) to clear heat and engender fluids.If damp-heat transforms into fire or lingers internally,use
Bái Tóu Wēng Tāng
(Pulsatilla Decoction,白头翁汤),
Yīn Chén Hāo Tāng
(Virgate Wormwood Decoction,茵陈蒿汤) and
Gān Lù Xiāo Dú Dān
(Sweet Dew Toxin-Removing Elixir,甘露消毒丹) to clear heat and resolve dampness.If a warm-heat pathogen enters the
ying
-blood level manifesting with unconsciousness,maculae or blood patterns,use
Qīng Yíng Tāng
(
Ying
Level Heat-Clearing Decoction,清营汤),
Xī Jiăo Dì Huáng Tāng
[Rhinoceros Horn (Generally use buffalo horn as substitute product) and Rehmannia Decoction,犀角地黄汤)] and
Shén Xī Dān
(Spirit-Like Rhinoceros Horn Elixir,神犀丹) to clear heat,resolve toxins,and cool blood.For exuberant fire-toxin appearing with erysipelas,sores,carbuncles,and furuncles,use
Huáng Lián Jiě Dú Tāng
(Coptis Toxin-Resolving Decoction,黄连解毒汤) and
Wǔ Wèi Xiāo Dú Yǐn
(Five Ingredients Toxin-Removing Beverage,五味消毒饮) to clear fire and resolve toxins.If liver and gallbladder fire are exuberant,use
Lóng Dăn Xiè Gān Tāng
(Gentian Liver-Draining Decoction,龙胆泻肝汤) to clear the liver and purge fire.
This method is applicable for various kinds of bleeding syndromes in children such as nose bleeding,gum bleeding,bloody urine,bloody stools,or purpura.Commonly used formulas are Xī Jiăo Dì Huáng Tāng (Rhinoceros Horn and Rehmannia Decoction,犀角地黄汤), Yù Nǚ Jiān (Jade Lady Decoction,玉女煎), Xiăo Jì Yǐn Zi (Field Thistle Drink,小蓟饮子) and Huái Huā Săn (Sophora Flower Powder,槐花散).Some Chinese medicines demonstrate hemostatic effects such as sān wèi shēn sān qī (Sole Notoginseng), bái jí (Bletillae Rhizoma), xiān hè căo (Agrimoniae Herba) and yún nán bái yào (Yunnan White Medicinal Powder,云南白药).Pediatric bloody patterns are often caused by frenetic movement of blood heat and blood flow outside channels.
This method is applicable for children with various kinds of intestinal worms,such as roundworm,pinworm,etc.Roundworms are especially changeful and may cause various complications such as syncope due to ascariasis(ascariasis of biliary tract),abdominal enterozoic mass (Ascaris intestinal obstruction).In these situations,it is first necessary to quiet worms and ease pain with Wū Méi Wán (Mume Pill,乌梅丸) before expelling the worms.The commonly used prescriptions for expelling roundworms are zhuī chóng wán (Worm-chasing Pills,追虫丸)and xià chóng wán (Worm-expelling Pills,下虫丸).Effective medicines for expelling roundworms are shǐ jūn zǐ (Quisqualis Fructus) and kǔ liàn pí (Meliae Cortex). Bīng láng (Arecae Semen) can be used to expel fasciolopsis.Medicinals for expelling pinworms are dà huáng (Radix et Rhizoma Rhei) and shǐ jūn zǐ (Quisqualis Fructus)which are decocted together and combined with băi bù (Radix Stemonae) as an enema.
This method is mainly applicable for young children with patterns of excess in feeding and food stagnation,such as food accumulation,vomiting and diarrhea due to food damage and malnutrition.Children’s spleen and stomach are weak and cannot transport and transform properly,leading to vomiting,diarrhea,anorexia,and abdominal pain in mild cases,and in severe cases,malnutrition that affects their growth and development.Commonly used formulas include Băo Hé Wán (Harmony-Preserving Pill,保和丸), Xiāo Rǔ Wán (Milk Digestion Pills,消乳丸), Jī Nèi Jīn Fěn (Chicken Gizzard-Skin Powder,鸡内金粉)and Zhǐ Shí Dăo Zhì Wán (Immature Bitter Orange Stagnation-Moving Pill,枳实导滞丸).Among the medicinals that promote digestion and remove stagnation, mài yá (Fructus Hordei Germinatus) is good at promoting milk digestion, shān zhā (Fructus Crataegi) promoting digestion of meat and greasy foods, shén qū (Massa Medicata Fermentata) promoting digestion of grain and resolves grain stagnation, lái fú zǐ (Semen Raphani) resolving wheat-type food accumulation and jī nèi jīn (Endothelium Corneum Gigeriae Galli) resolving all types of food stagnation while stimulating the appetite.
This method is mainly applicable for children with convulsions,epilepsy and other syndromes.Children tend to develop exuberant pathogenic heat,while the extreme heat will stir the liver wind,or induce fluid,generating phlegm to block the collaterals.Orifices’ blockage will result in infantile convulsion.Commonly used formulas are Zǐ Xuě Dān (Purple Snow Elixir,紫雪丹), Zhì Băo Dān (Supreme Jewel Elixir,至宝丹), Ᾱn Gōng Niú Huáng Wán (Peaceful Palace Bovine Bezoar Pill,安宫牛黄丸), Sū Hé Xiāng Wán (Storax Pill,苏合香丸) and Líng Jiăo Gōu Téng Tāng (Antelope Horn and Uncaria Decoction,羚角钩藤汤).
This method is mainly applicable for edema in children with scanty urination due to water dampness accumulation and retention.Yang edema involves pathogen dampness accumulation and dysfunction of the spleen in transportation with water dampness diffusing into the ski; Yin edema involves spleen-kidney yang deficiency with an inability to transform qi and promote urination with water and dampness accumulation.Commonly used formulas for yang edema are Má Huáng Lián Qiáo Chì Xiăo Dòu Tāng (Ephedra Herb,Weeping Forsythia Capsule and Adzuki Bean Decoction,麻黄连翘赤小豆汤), Wǔ Líng Săn (Five Substances Powder with Poria,五苓散), Wǔ Pí Yǐn (Five-Peel Beverage,五皮饮),and Yuè Bì Jiā zhú Tāng (Maidservant From Yue Decoction plus Atractylodes Macrocephala,越婢加术汤); commonly used formulas for yin edema are Fáng Jǐ Huáng Qí Tāng (Stephania Root and Astragalus Decoction,防己黄芪汤), Shí Pí Yǐn (Spleen-Strengthening Beverage,实脾饮),and Zhēn Wǔ Tāng (True Warrior Decoction,真武汤).In addition, chē qián zǐ (Plantaginis Semen), jì cài huā (Shepherds Purse Inflorescence) and yù mǐ xū (Maydis Stigma) can be used to induce diuresis and disperse edema.
This method is mainly applicable for children with spleen-stomach deficiency and qi-blood insufficiency manifesting as diarrhea,malnutrition and a weak physique after illness.Commonly used formulas include Shēn Líng Bái Zhú Săn (Ginseng,Poria and Atractylodes Macrocephalae Powder,参苓白术散), Qī Wèi Bái Zhú Săn (Seven-Ingredient Macrocephalae Powder,七味白术散), Yì Gōng Săn (Special Achievement Powder,异功散),and Bǔ Zhōng Yì Qì Tāng (Center-Supplementing and Qi-Boosting Decoction,补中益气汤).A single herb powder of huái shān yào (Rhizoma dioscoreae) mixed with water is effective in fortifying the spleen and checking diarrhea.Qi deficiency and spleen deficiency are closely related.Treatment of qi deficiency usually focuses on fortifying the spleen while always supplementing qi,so they are co-independent.Since spleen deficiency causing the qi weakness leads to transformation failure,children often have symptoms such as indigestion and loss of appetite,so formulas for fortifying the spleen and replenishing qi can be combined with medicinals for regulating qi and promoting digestion,such as shā rén (Fructus Amomi), huò xiāng (Agastachis Herba), chén pí (Pericarpium Citri Reticulatae), shān zhā (Fructus Crataegi), shén qū (Massa Medicata Fermentata),and jī nèi jīn (Endothelium Corneum Gigeriae Galli).
This method is mainly applicable for children with syndromes of innate insufficiency,kidney qi deficiency failing to receive qi,such as infantile metopism,five retardations,five weaknesses,enuresis and asthma.Commonly used formulas include Liù Wèi Dì Huáng Wán (Six-Ingredient Rehmannia Pill,六味地黄丸), Jīn Guì Shèn Qì Wán (Golden Cabinet’s Kidney Qi Pill,金匮肾气丸), Sāng Piāo Xiāo Săn (Mantis Egg Shell Powder,桑螵蛸散) and Shēn Gé Săn (Ginseng and Gecko Powder,参蛤散).During childhood it is common to have concurrent disorders of the liver and the kidney,concurrent disorders of the spleen and the kidney,or concurrent disorders of the lung and the kidney.Therefore,medicinals that nourish the liver,fortify the spleen and supplement the lung should be added when applying this method.
This method is mainly applicable for various blood stasis conditions,such as panting and cough presenting with blue and purple lips and spots on the skin,and stabbing abdominal pain with a fixed location,and palpable and abdominal masses.Commonly used formulas are Táo Hóng Sì Wù Tāng (Peach Kernel and Carthamus Four Substances Decoction,桃红四物汤), Xuè Fǔ Zhú Yū Tāng (Blood Mansion Stasis-Expelling Decoction,血府逐瘀汤), Shào Fù Zhú Yū Tāng (Lower Abdominal Stasis-Expelling Decoction,少腹逐瘀汤),and Táo Hé Chéng Qì Tāng (Peach Kernel Qi-Guiding Decoction,桃核承气汤).“Qi is the commander of blood; when qi is in motion it enables the blood to circulate normally”; thus when applying formulas to invigorate blood and dissolve stasis,qi moving medicines are often added to enhance the formula actions.
This method is mainly applicable for children with critical conditions of original yang decline and collapses presenting with the pale complexion,spirit fatigue,cold limbs,profuse sweating,weak breathing,and barely percepti-ble thready pulses.In this situation,formulas that powerfully supplement yang qi should be used urgently to save the patient’s life,such as Sì Nì Tāng (Frigid Extremities Decoction,四逆汤) and Shēn Fù Lóng Mǔ Jiù Nì Tāng (Ginseng,Aconite,Dragon Bone,and Oyster Shell Counterflow Decoction,参附龙牡救逆汤).
External therapy refers to the method of administration on the surface of the skin (mucosa) or in vitro,in addition to the oral administration.Because many children are reluctant to take decoctions or fear injections or have administration difficulties,the external treatment is easy for children to accept.Children have delicate skin and clear zang qi,so external therapy acts rapidly.Clinically it can be used alone or in combination with internal therapies to treat children’s common diseases and frequently occurring diseases.At present,external treatment methods are medicinal applications referring to as pasting,fumigating,washing,insufflating,dripping,enema,and smelling.
This therapy uses the liquid or the vapor of boiled decoctions to wash or steam the skin.Fumigating and washing is applicable for summer fever without sweat with decocted xiāng rú (Herba Moslae) to bring down the fever by sweating.It can also be used in the early stage of measles to promote eruptions. Má huáng ( Herba Ephedrae), fú píng (Herba Spirodelae), yán suī zǐ (Coriandrum sativum)and xī hé liǔ (Cacumen Tamaricis) can be used to scrub the head and limbs; this decoction can also be steamed into the air,allowing the vapor to contact the child’s body surface.
This method involves grinding fresh medicinals into a paste by adding water or vinegar to the powder to prepare a medicinal liquid,which is then spread onto the body surface.Choose one from fresh mă chǐ xiàn (Portulacae Herba),cactus, qīng dài (Indigo Naturalis), Jīn Huáng Săn (Golden Yellow Powder,金黄散) and zǐ jìn dìng (Purple gold Troch,紫金锭) to paste onto the cheeks to treat mumps.Three powdered wú zhū yú (Evodiae Fructus) and one powdered dăn nán xīng (Arisaema cum Bile) are mixed with rice vinegar into paste to spread onto KI 1 ( yǒng quán ) to treat dribbling.
This method is to apply and bind medicinals to a localized skin area.For example,dressing the navel area with pí xiāo (Mirabilite) can be used to treat food stagnation or accumulation.For night sweating,mix powdered wǔ bèi zǐ (Galla Chinensis) with vinegar and dress the navel area.
This method is to wrap specific stir-fried medicinals with a piece of cloth and then iron them onto skin.For abdominal pain,compress the abdomen with stir-fried salt; for uroschesis,compress the navel area and lateral lower abdomen with stir-fried raw shallot and salt.
Medicinals are prepared in the form of an ointment,medicinal cake,or by sprinkling medicinal powder onto an ordinary plaster for sticking onto the body surface.Infantile diarrhea due to deficiency cold can be treated by sprinkling dīng xiāng (Flos Caryophylli)and ròu guì (Cortex Cinnamomi) powder onto a normal plaster and applying it onto the navel area.During three periods of the hottest part of summer,asthma can be treated by grinding yán hú suǒ (Rhizoma Corydalis), bái jiè zǐ (Semen Sinapis), gān suì (Radix Kansui)and xì xīn (Radix et Rhizoma Asari) into a powder and mixing with ginger juice to make a medicinal cake to apply onto BL 13 ( fèi shù) ,BL 43 ( gāo huāng ) and băi láo (EX-HN15).
Medicinal liquid or powder is scrubbed onto certain locations.Use bīng péng săn (Borneol and Borax Powder,冰硼散) to scrub the oral cavity,or use mild salty water or a decoction of jīn yín huā (Lonicerae Japonicae Flos) and gān căo (Radix et Rhizoma Glycyrrhizae) to cleanse the mouth to treat thrush and aphtha.
It is a kind of external therapy which is to make the powdered medicinals into a bag for wearing on the chest,the abdomen or a pillow.Commonly used medicinals are shān nài (Kaempferiae Rhizoma), cāng zhú (Rhizoma Atractylodis), bái zhǐ (Radix Angelicae Dahuri-cae), shā rén (Fructus Amomi), dīng xiāng (Flos Caryophylli), ròu guì (Cortex Cinnamomi), gān sōng (Radix et Rhizoma Nardostachyos), dòu kòu (Fructus Amomi Rotundus), chén xiāng (Lignum Aquilariae Resinatum), tán xiāng (Lignum Santali Albi) and ài yè (Folium Artemisiae Argyi),from which medicinals are chosen to make perfume satchels,abdomen wraps up or perfume pillows.If used regularly,they have the function to repel foulness,remove toxin,improve appetite,prevent and cure diseases.
Tuina or infantile massage is a traditional therapeutic method for the treatment of pediatric diseases.It achieves a curative effect by promoting qi and blood circulation,freeing movement of the channels and collaterals,settling the spirit,and harmonizing the zang-fu organs.Clinically tuina is often applied to pre-school children with fever,constipation,diarrhea,abdominal pain,anorexia,torticollis and flaccidity syndromes and other diseases.The younger,the better.Tuina manipulation techniques should be nimble and gentle.Acupoint selection and operation methods differ from those of adults.The most common manipulations are pushing,grasping,kneading,pressing,pinching,etc.Commonly used acupoints on upper limbs are liù fǔ , tiān hé shuǐ ,and sān guān ; palm: dà cháng , pí tǔ ,and băn mén ;lower limbs: ST 36 ( zú sān lǐ ) and SP 6 ( sān yīn jiāo ); back: DU 14 ( dà zhuī ),BL 20 ( pí shù ),BL 23( shèn shù ),BL 25 ( dà cháng shù ), qī jié ,and guī wěi ; abdomen: qí zhōng ,ST 25 ( tiān shū ), dān tián ,and RN 6 ( qì hăi ).
Spine pinching therapy is a common therapeutic manipulation in infantile tui na.It can be done by massaging the DU meridian and gallbladder meridian to regulate yin and yang,remove obstructions in the channels and collaterals,promoting qi,activating blood,and revive zang-fu organ functions to prevent diseases.The operation procedures:The patient lies on a prostrate position.The practitioner keeps both hands semi-clenched.The two index fingers touch the patient’s spine,two thumbs stretch,pinch and pull the muscles along the patient’s spine with the two index fingers.Then,the index fingers move forward and the thumbs move backwards,making a turning-over movements and both hands pinching along the spine at the same time; or: the practitioner makes his thumbs opposite to his index fingers,middle fingers and fourth fingers of both hands in the form of pinching.Lift the skin along the spine from the lumbosacral to acupoint DU 14 ( dà zhuī ).So repeat 3–5 times.After the third time,lift the skin every three pinches.Do it once a day for 6 days as a course of treatment.For children with back skin infections or purpura,this method is prohibited.
It includes acupuncture therapy and moxibustion therapy.Acupuncture therapy is commonly used in the treatment of pediatric enuresis,asthma,diarrhea,infantile convulsion,arthralgia,and encephalitis sequelae,etc.The acupoints used in children’s acupuncture are basically the same as those of adults.However,because the children are reluctant to receive acupuncture,shallow needling or quick needling is generally adopted,as well as wrist-ankle acupuncture,auricular acupuncture and laser radiation on acupoints.Children are usually given indirect moxibustion with moxa,with the appropriate distance from the skin.It is appropriate when the skin is slightly red and warm.Be careful to prevent skin burns.
Needling sì fèng (EX-UE 10) is a common manipulation method in pediatric acupuncture.The sì fèng points belong to the extraordinary points and are located at the middle of the transverse creases of the first interphalangeal joints of index,middle and little fingers,where the three hand yin meridians run.Needling sì fèng points can clear heat,relieve restlessness,unblock meridians and collaterals,and harmonize the zang-fu organs.It is often applied for infantile anorexia and malnutrition.The operation procedures: first sterilize the local skin,insert a three-edged needle into the acupoint about 1 fen (1/10 cun ),followed by finger-pressing to extract some yellow-white fluid.
Cupping is a physical therapy used to treat diseases by creating local congestion via negative pressure by sticking a series of specially-made cups or jars on either afflicted part or points.It can promote blood flow,movement of nutrient qi and defense qi,expel wind and cold,relax muscle and tendons,and relieve pains,and is often applied for pneumonia,cough,asthma,abdominal pain and enuresis.Bamboo or glass cups are commonly used for children with smaller diameters for a short duration.When removing the cup,firstly press the skin around the rim with the thumb or index finger to allow the air in,and the cup can easily be removed.Do not remove the cup with force.Now rubber or plastic cups are also used.It only needs to evacuate the cup with force (which depends on the suction required),then invert and attach the cup to the selected region; then stop extrusion and the cup can suck the skin; when removing the cup,press the cup again and it is removed with the disappearance of the negative pressure inside.This therapy is prohibited for children with convulsion due to high fever,edema,bleeding,emaciation,skin allergy,and skin infections.
Dietetic therapy,or food therapy,is a method for regulation of the body function,disease prevention,and health promotion by using the nature and flavor and components of food acting on the relevant zang-fu organs,in the guidance of TCM theories.
Dietetic therapy in TCM has two main categories.One is the food used alone,such as rice,flour,fruit,vegetables,eggs,poultry,livestock,and fish which are all used in this therapy.Tea of fresh ginger and brown sugar is applicable for wind-cold type of common cold by releasing exterior and dissipating cold; apple butter for infantile diarrhea; carrot porridge for infantile cough and dyspepsia by expelling phlegm to arrest coughing,descending qi,relieving the abdominal heaviness,promoting digestion and stopping stasis; lamb liver for infantile night blindness by nourishing blood,tonifying liver and improving vision.The other category refers to food and medicine processed for diet therapy. Bā zhēn gāo (eight dainties cake,八珍糕)is applicable for infantile anorexia and malnutrition by invigorating spleen and promoting transportation of the spleen; purslane porridge for diarrhea due to spleen deficiency with dampness retention by clearing intestines,removing dampness and stop diarrhea;honeysuckle flower distillate for heat rash by clearing heat and removing toxin; pear cream for pulmonary cough by moistening lung for arresting cough.The medicinals in the latter category are often those who are both food and medicine,such as gān căo (Radix et Rhizoma Glycyrrhizae), wū méi (Mume Fructus), chén pí (Pericarpium Citri Reticulatae), shā rén (Fructus Amomi), suān zăo rén (Ziziphi Spinosae Semen), jué míng zǐ (Cassiae Semen), lái fú zǐ (Semen Raphani), qīng guǒ (Canarii Fructus), luó hàn guǒ (Momordicae Fructus), bái guǒ (Semen Ginkgo), xiāng yuán (Citri Fructus), ròu dòu kòu (Myristicae Semen), ròu guì (Cortex Cinnamomi), jú huā (Chrysanthemi Flos), bò he (Menthae Herba), huò xiāng (Agastachis Herba), fú líng (Poria), jī nèi jīn (Endothelium Corneum Gigeriae Galli),and mă chǐ xiàn (Portulacae Herba),etc.Food and medicine diet generally should not be given to normal children,and must not be taken for long.
Dietetic therapy is performed differentially according to the characteristics of children and varies with from person to person.Different food should be selected to promote health,and much attention paid to dietetic contraindications.In this therapy,children usually have porridge,soup,beverage,juice,thick soup,distillate,tea,cakes,cream,sugar and so on.Among them,porridge is the most widely used.Although the use of dietary therapy is broad,the effect is relatively mild,clinically only as an adjuvant therapy in addition to the major methods.
1.How to understand the concept of “finger venules inspection” in pediatrics?
2.State the characteristics of medication and dosage of decoction in children.
3.State the function,operation,and points for attention in pediatric spine pinching therapy.